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Archive for December, 2021

Most days, doctoring is just simply HARD, in this BRAVE New World, post-COVID. Other days like today, it flows easily wherein my patients are thriving and actually, feel well enough to reciprocate “karuna.”

But Alas! I hit a jackpot of a feast. Lucky me, I came on a Tuesday whereupon the weekly volunteer cooking crew were convening to cook a specialty dish.

I saw a record 6 housecalls today and thankfully all the patients ranging from 71 to 86 are doing well—some are even “thriving!” But the best part is rolling up to the Buddhist temple to see my VIP abess at 2pm, I was famished because I had not had time for lunch yet.

Today, they were making about 1000+ Bánh Bột Lộc (vegetarian tapioca flour tamales-like goodies, filled with sautéed tofu, carrots, leeks, black fungus and shiitake mushrooms, wrapped in banana leaves then steamed to a gooey heavenly-deliciousness.)

Banana leaves used to wrap the Banh Bot Loc
Tapioca rice dough wrapped in banana leaves, filled with tofu, carrots, leeks, black fungus: steamed to perfection.

After taking care of my VIP housecall patient, I was spoiled by an 8 course vegetarian lunch—village style, along with the cooks.

I left the temple to see my last elderly couple, a husband and wife—barely able to live on their own. The 85 yo husband (a retired pharmacist) survived COVID pneumonia under our meticulous “hospital-at-home” level care last Christmas.

Nearly a year later, he’s even stronger than his per-COVID baseline. Mostly because he now has #karunahealthcare and a whole team watching over him. His moderate-severely demented wife (also a retired pharmacist who weighs all of 72 lbs) broke her arm last April. That broken humerus is all healed. She even gained 6 pounds in the last 3 months!

At baseline, both have ataxic, unsteady gaits. Their risks for future falls are great. I have done the best I can to get home-based physical therapy for strengthening and gait training. I have prescribed and injected them every 6 months with special medications to fortify their bones, while supplementing with Vit D and Calcium. I also pray regularly that they don’t suffer more injuries.

Our interdisciplinary medical-nursing-social work team calls to check on them. Together, we work hard to help them remain living in their single-story home “safely.” But today, this fragile yet resilient couple were unusually cheerful, doing reasonably well, all things considered in this second winter of COVID. They thankfully have both received their 3rd COVAX boosters timely.

I review and remind them to make sure they get their 2-dose Shingles and Prevnar/pneumonia-vaccines—if they haven’t already. They don’t remember so I write down for them to check with their pharmacy where they get all their shots.

We reviewed their medications, to make sure they are taking them properly. I send electronic refills to make sure they have enough until I see them in the New Year.

I check their weights, vital signs and oxygen saturations: all stable. I examine them both to make sure his coronary artery disease and chronic heart failure are compensated. His legs are not swollen and his chest is clear!

I review and explain in detail their recent labs (printed out for their records). Cheerfully, I congratulated them: all their blood counts, kidney, liver, cholesterol, sugar, thyroid, urine tests being improved, actually.

Upon my leaving after attending to their chronic, complex conditions, they send me off with lotsa thoughtful homegrown gifts—for the Holidays. I received 10 pounds each of lemons, limes and persimmons—which grow “automatically” and prolifically in their backyard without any gardening efforts on their part. Being childless, this elderly couple relies on me for their survival.

In the last year during COVID shelter-in-place, I have enlisted the help when needed, of a home health agency that calls them regularly to check on their status. Intermittently, I have deployed nurses, nursing aids, physical therapists as needed, when they got acutely ill such as when he caught COVID pneumonia; or when she fell, and broker her right arm.

For their sustenance, I collaborated with a local Đa Lạc Viên Evergreen Adult Day Care Center, to set up hot, delicious VietNamese-cuisine “Meals-On-Wheels” program. For over a year, this couple has received hot meals, directly delivered to their homes, every other day. These delicious, nutritious meals allow them to be able to live independently still, in their own home.

Otherwise, they would be forced to move into an assisted or nursing home. Both are too frail and forgetful now, to cook safely for themselves. Neither one can drive anymore. They must rely on friends, community members or Lyft/Uber drivers to get them to appointments, go grocery shopping, pick up essentials at the pharmacy, or run errands etc.)

I am privileged beyond measure to provide this high-touch, life-preserving care for our revered, high-needs elders.

Amazingly, I was able to finish up and get home before 5pm, just in time to deliver the loot of 30 Bánh Bột Lộc I brought from the temple earlier that afternoon. These Hue-specialty dishes were such a meaningful addition for the family altar on the occasion of my maternal grandmother’s Đám Giỗ, aka the anniversary of her passing from this earthly life over 40 years ago.

These authentically Viet dishes (made by communal hands from our homeland of Huế, VietNam) were offered, in addition to over a dozen dishes lovingly and singularly hand-made-with-love, by my beloved maman.

Homemad-with-love vegan feast offered to honor my paternal grandmother “Ba Noi” on the anniversary of death, decades ago.

She had been cooked for two days other amazingly healthy and colorful vegan dishes in honor of her late, mother-in-law. 🙏🏼😇

This high-intensity, complex-care, high-touch medical practice is cumbersome and meticulous. I cannot see that many patients daily. Naturally, I make a fraction of the money I used to, making these housecalls compared to clinic or hospital medicine. But my intangible riches are inestimable. Perhaps the greatest gift of this high-touch housecall practice is that I finally attain (at least for one day) that ever-elusive #worklifebalance that nowadays, seem out of reach for so many burning out doctor-colleagues. #goodkarma #blessed #karmiccapital #joysofdoctoring #begood #dogood 🙏🏼💜😇☯️😋👩🏻‍⚕️⌛️📿

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